@layout("/common/_form.html",{js:["/assets/modular/system/btyCwFine/btyCwFine_add.js"],css:["/assets/expand/module/formSelects/formSelects-v4.css"]}){

<form class="layui-form" id="btyCwFineForm" lay-filter="btyCwFineForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">财务人员<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="cwry" name="cwry" placeholder="请输入财务人员" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">妖码<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yaoma" name="yaoma" placeholder="请输入妖码" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">店名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="dm" name="dm" placeholder="请输入店名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">店的财务码<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="cwm" name="cwm" placeholder="请输入店的财务码" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">月份<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="month" name="month" placeholder="请输入月份" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">状态：0->待审核1->通过;2->撤回;3->已同步货赔<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="status" name="status" placeholder="请输入状态：0->待审核1->通过;2->撤回;3->已同步货赔" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">门店编号-对应bty_brand表bh<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="mdbh" name="mdbh" placeholder="请输入门店编号-对应bty_brand表bh" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">备注<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="remark" name="remark" placeholder="请输入备注" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">店长手机<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="mobile" name="mobile" placeholder="请输入店长手机" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">店长<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="shopownerView" name="shopownerView" placeholder="请输入店长" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">财务罚款<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="cwDeduction" name="cwDeduction" placeholder="请输入财务罚款" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}